Health care from a trailer: Medical support in a coal town

The town of Dingess, W.Va., is about 13 miles from the center of Logan, but it's a nearly 30-minute drive and seems like a world apart.

One might think Dingess, with no major restaurants or retail stores, would be an uncommon place to find a top-notch medical care provider. However, in the 1980s, on the edge of town, the Dingess Clinic provided health care to nearly 30 coal- mining families from a modest trailer.

"There were no physicians ever in that area," said Jim Wright, a 1984 WVSOM graduate who was the clinic's director for about three years. "I started out seeing eight to 10 people a day, but after they got used to the idea that I was there I started seeing about 30 people a day."

Wright was fulfilling a National Health Service Corp scholarship at Logan General Hospital that requires recipients to complete residency in a rural or underserved area. He spent much of his time at the hospital working emergency room shifts. The hospital was looking into setting up satellite clinics in nearby underserved areas, thus the creation of the Dingess Clinic.

While providing medical care from a trailer may not be the most idyllic scenario for new physicians, Wright was just happy to serve a rural community.

"Although I grew up in New Jersey, it was a farming area," the family medicine physician said. "I like the concept of returning to the basic ways of life from the past. My family always had a garden. I just liked rural life."

Serving as a physician at the Dingess Clinic, Wright saw many of the same ailments and health issues he saw at the Logan hospital — with the main disparities from Dingess patients caused by coal-related health risks. Wright treated many patients with chronic lung disease, which was a result of working underground, as well as depression.

"Many people with injuries would just put some duct tape over an injury and see what happened because they didn't have a car or drivers license and weren't able to make it up over the mountain," he said. "Because we were so isolated, I did things there that I would never do when I worked other places. It was good to have a clinic in that area."

To accommodate patients without reliable transportation, Wright also made home visits about once a week. Sometimes that meant hopping a ride in the back of a four-wheel drive truck owned by the local coal mine just to get to another side of the mountain.

Bob Foster, D.O., WVSOM's associate dean for osteopathic medical education, remembers making site visits in the Logan area and visiting Wright in the Dingess trailer. At the time, Foster was WVSOM's associate dean for clinical education.

"This trailer clinic is often what these communities need. Access to health care by these so-called first line of defense doctors. Mingo County was probably one of the most underserved of all counties at that time and this trailer was the jewel of Dingess, W.Va."

The Dingess Clinic epitomized WVSOM's mission of providing medical care to residents of West Virginia in the most underserved areas, Foster said. "In most of these rural areas doctors can make a great impact on patients' health. Our doctors are doing that."

Before Wright became a D.O., he spent three years in the military, worked construction where he built houses, graduated from Concord College and taught in Summers County schools. He was a County Health Officer for Logan County for three years and later was the director of graduate medical education for the osteopathic training program.

He spent more than 16 years in upstate New York. For three years, he was the emergency room director at the Adirondack Regional Hospital and clinics in rural areas, but found he missed being in West Virginia. He started working at the Monroe Health Center in Union where he was medical director for seven years.

Wright recently retired in November of 2016, but because of his interest in providing an osteopathic approach to medicine he continues to teach students at WVSOM. He is a table trainer for osteopathic manipulative medicine, helps teach a suturing Clinical Skills lab and teaches a Clinical Skills lab regarding heart murmurs and rhythm strips during the fall semester.

"I really enjoy being an osteopathic physician. I still enjoy it. It's so exciting," Wright said. "There is always something interesting going on in medicine so it gives you a real opportunity to have a meaningful life."

From a trailer on the top of a mountain in the Allegheny Mountains, to the Adirondack Mountains and back, Wright said being a physician in America's most underserved communities is one of the most rewarding careers.